Metal fume fever a persisting problem, toxicologists say

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“Monday morning fever” – metal fume fever – is a persisting problem, despite changes in modern-day work practices, researchers say. Workers in the home and also students doing metal work are at great risk.

First described in 1822, it is a disease which may have been forgotten by GPs and ED doctors but is well known to toxicologists.

Dr Anselm Wong and colleagues from the Emergency Department at Melbourne’s Austin Hospital and Victorian Poisons Information Center analyzed all metal fume fever-related calls to the Victorian Poisons Information Centre between June 2005 and December 2010.

Among the study's findings:

• They found 85 reported exposures, mostly in males (82 – 96% of cases).
• Almost all (84 – 99%) of these calls were about adults.
• Most (81 – 95%) of the callers reported symptoms occurring within 24 hours, and 53% of the exposures occurred in the workplace.
• The most frequent days of exposure with symptoms were Monday (20 – 24%) and Tuesday (18 – 21%).
• The most common symptoms were fever, headache, and chills.
• All of the calls were people involved in welding metal, zinc being the most common (38%).

The researchers concluded that metal fume fever may still be a public health issue and potentially an indicator of poor work place practices.

Chronic respiratory disease is the fourth leading cause of death of Australasians and this study is an indicator that further efforts are required to ensure safe workplace practice and minimise potentially harmful exposures.

“In the workplace, prevention is the key to this disease – such as avoidance of direct contact with toxic metal fumes, improved engineering controls including exhaust ventilation systems, personal protective equipment such as respirators, and education of workers on the features of the disease.

“However, people in the workshop at home or students doing metal work may not have access to all of these.”

Source: Australasian College for Emergency Medicine

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